Exchanges hope to sail through shutdown

If Congress lets the federal government "shut down" tomorrow, can the new public exchanges open on time?

State and federal officials say they believe the Patient Protection and Affordable Care Act (PPACA) can open tomorrow, on schedule, and operate normally for a while even if the federal government has to function without "enacted annual budget appropriations."

The Centers for Medicare & Medicaid Services (CMS), an arm of the U.S. Department of Health and Human Services (HHS), is in charge of overseeing state efforts to set up state-based exchanges. It's also in charge of federal efforts to run exchanges in states that are letting HHS handle the job.

According to an HHS 2014 contingency plan, CMS activities -- including components of PPACA exchange implementation -- would continue "largely without disruption." HHS has put those activities in a category for "activities that involve the safety of human life and protection of property."

HHS has given implementing PPACA a higher priority than the annual seasonal flu program, outbreak detection and senior nutrition programs.

Officials at the locally run exchanges in Oregon and the District of Columbia said they were not aware of any issues related to the federal budget fight that could affect exchange operations tomorrow.

Similarly, in North Dakota, a state that will have an HHS-run exchange, officials said they had not heard anything about the possibility that a shutdown could delay the launch of the exchange program in their state.

At Health Republic Insurance of New York -- one of the new nonprofit, member-owned health insurance cooperatives created by PPACA to help increase the level of competition on state exchanges -- spokeswoman Katie James said that company has always planned to sell coverage both on and off the New York exchange.

"Health Republic Insurance of New York will be open for business tomorrow," James said.